Facility Evaluation Report

On 11/19/2021 at 9:00 AM, Licensing Program Analyst (LPA) C. Lin arrived announced to conduct Pre-licensing Required inspection. LPA met with Administrator, Sara Trail and explained the purpose of the visit. The facility currently has no clients.

LPA toured facility including but not limited to 5 bedrooms, 4 bathrooms, 1 office, kitchen, common areas and backyard. Bedrooms and living rooms were equipped with the proper furniture. Bathrooms were equipped with non-skid mats. Linens and hygiene supplies were observed inside a cabinet. There is sufficient lighting throughout facility. Room temperature was maintained at 69 degrees F and hot water temperature was maintained at 110 degrees F. First-aid kits were observed to be complete. Smoke detectors and carbon monoxide were operational. Fire extinguisher was purchased on 08/01/2021. LPA observed the facility had the necessary posters in posted in common areas (i.e. Complaint poster, Personal Rights, Rights to Council, Visitation policy, Emergency Disaster Plan).

No deficiencies cited during the pre-licensing inspection. LPA observed the facility is ready to be licensed. However, this report will be submitted to the central application unit (CAU) and a final review of the application will be conducted. This facility is not yet licensed and is subject to final approval by CAU. Additional requirements may still be required.

Exit interview conducted and a copy of this report provided.